EpiEMS
Forum Deputy Chief
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It seems to be a national epidemic. <_<
There must be some areas that aren't as bad (thinking Wake, and parts of Texas).
What is your EMS system?
- Thread starter ItsTheBLS
- Start date
It seems to be a national epidemic. <_<
There must be some areas that aren't as bad (thinking Wake, and parts of Texas).
So on most of your calls you get FD? Also, do you find it harder handling 911 calls with only an EMT-B partner?
What is your opinion on Jersey's 2-medic fly car system? Do you or anybody else here think it's something that's going to last for much longer? Is it something that's simply going to stay isolated? Or something that will expand?
I always thought it was kind of silly. The only reason to have two medics is for high acuity calls which don't occur often enough to justify constant 2 medic staffing, especially since you can just call for the second medic who is just in another vehicle.
I've only worked in systems with single medic fly cars, so maybe I'm biased, but we never had an issue with not enough medics on scene, assuming the EMTs also had their stuff together.
If the EMTs didn't, it was gonna be a cluster anyway.
NomadicMedic
I know a guy who knows a guy.
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Why is it bad? This week I work dayshift on Monday and Tuesday, and Wednesday night and Thursday night. I have Friday, Saturday, Sunday and Monday off. We're not so busy that we're getting crushed, I usually sleep at night. It works for me. It's certainly better than 24 hour shifts.
Trashtruck
Forum Captain
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Agreed. I don't think my system(or giant cesspool of entropy)is even real. It's more of a forced reality when I go into work.
Fire based. I think that covers everything.
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This.
Shishkabob
Forum Chief
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Depends on the call and on the city, but yes, most calls do get FD, though I cancel them as soon as I can as they really aren't needed / beneficial on most calls. If I could keep them from getting dispatched to all but the most serious of calls (or fat people), I would in a heatbeat.
Nope, not hard with 'just' an EMT. I was pretty much raised in a rural system where I had an EMT and a bunch of vollies, so I had to learn self-reliance early on anyhow. Now if the call is BlS, I don't have to work it. With a second medic, we typically switch every other call which gets annoying.
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DrParasite
The fire extinguisher is not just for show
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some fire department, to ensure no one got stuck working days or night or weekends. it's great if you can sleep at night, and if it's slow, but it does get old if you are doing 12 calls during your night shifts. typically they do 10s and 14s, 10 hour days and 14 hour night shifts.
as a Jersey EMS provider, I can say with near certainty that NJ's 2 medic fly car system isn't going anywhere. the only thing that will change is those two medics will start driving around in ambulances, especially with more an more ALS projects starting their own BLS system.
you won't see 1&1 anytime soon. in fact, many of the studies show that a paramedics who see only acutely sick patients are better than those who spend 80% of their shift dealing with non-life threatening patients.
as for those calls that it helps to have 2 paramedics, how about any person you cpap? or a multi system trauma with airway control? or a cardiac arrest? or someone you RSI? or a seizure patient who keeps twitching? or just a patient where you can't seem to get the IV, and want someone else to try?
ExpatMedic0
MS, NRP
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I worked this for a year and it sucks. I was an ALS fly car covering maybe 4 ambulance stations, so I never got a break.
RocketMedic
Californian, Lost in Texas
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Do you turf low-priority calls to private ambulance (Acadian), or is it a dual-response system?
El Paso Fire Department turfed quite a few patients (non-critical patients) to Elite/Life/Dominion, which I thought was a good idea. I still think the world of EPFD, they were excellent on my rides with them and they provided my wife with excellent care.
I'll toss mine in.
Private service with multiple 911 agreements in and around a large Texas city. Also multiple hospital agreements to include a children's hospitals teams. 2 other counties have us for 911/sole provider. Those 2 counties are rural and tend to be slow.
Staffing is medic/basic on ALS units and basic/basic on BLS transfer units. 3 CCT units are CCT medic/basic. Bari unit when needed is staffed by a mainline crew just for that call.
Most shifts are 12 hours on a 2-2-3 rotation. Assigned day or night. Only way to switch is to wait for an opening and have a request on file.
Street corner posting. We are so busy and move around so much that having stations wouldn't be that beneficial. Crews would just complain they didn't get to stay long.
Fire department first response on all 911 calls. Mix of volunteer, paid, combo. Most are BLS level. Couple are ALS level and can be scary when they decide to play before we get there. Most calls we can beat fire onscene and cancel them.
Areas range from city to rural with 5 min to 45 min transports. 2 helo services when needed. 2 level one trauma centers,multiple pedi hospitals etc. No lack of hospitals.
Private service with multiple 911 agreements in and around a large Texas city. Also multiple hospital agreements to include a children's hospitals teams. 2 other counties have us for 911/sole provider. Those 2 counties are rural and tend to be slow.
Staffing is medic/basic on ALS units and basic/basic on BLS transfer units. 3 CCT units are CCT medic/basic. Bari unit when needed is staffed by a mainline crew just for that call.
Most shifts are 12 hours on a 2-2-3 rotation. Assigned day or night. Only way to switch is to wait for an opening and have a request on file.
Street corner posting. We are so busy and move around so much that having stations wouldn't be that beneficial. Crews would just complain they didn't get to stay long.
Fire department first response on all 911 calls. Mix of volunteer, paid, combo. Most are BLS level. Couple are ALS level and can be scary when they decide to play before we get there. Most calls we can beat fire onscene and cancel them.
Areas range from city to rural with 5 min to 45 min transports. 2 helo services when needed. 2 level one trauma centers,multiple pedi hospitals etc. No lack of hospitals.
Christopher
Forum Deputy Chief
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I work for 3 systems.
County 1:
- County-based ALS transport (12h shifts, 6 24x7 ALS, 3 peak ALS, 1 supervisor QRV), primarily P+P, sometimes P+I/B
- County-based BLS patient care transport service
- 15+ volunteer/paid fire departments (mix of FR, B, and I level)
- 2 Paramedic transporting fire departments (I work for one of these), primarily P+B, 24x72's at both of them
- 2 hospitals in county, 3 hospitals in neighboring counties (2 are the trauma/pci centers we use)
County 2:
- Hospital-based ALS transport (12h shifts, 7 24x7 ALS, 4 peak ALS, 3 QRVs, 1 supervisor QRV), 99% P+P
- Hospital-based interfacility transport and HEMS
- City fire all EMT-B
- County fire all EMT-B
- One volunteer EMT agency does limited transport B+B
- 2 hospitals in county (1 is trauma/pci center)
Industrial:
- BLS transporting ambulance (volunteer staffing, 24x7x365 as folks are on shift for regular work)
- Member of County 2's mutual aid plan, utilizes same radio system/protocols/equipment/training schedule
- Technical rescue / industrial fire brigade as well
County 1:
- County-based ALS transport (12h shifts, 6 24x7 ALS, 3 peak ALS, 1 supervisor QRV), primarily P+P, sometimes P+I/B
- County-based BLS patient care transport service
- 15+ volunteer/paid fire departments (mix of FR, B, and I level)
- 2 Paramedic transporting fire departments (I work for one of these), primarily P+B, 24x72's at both of them
- 2 hospitals in county, 3 hospitals in neighboring counties (2 are the trauma/pci centers we use)
County 2:
- Hospital-based ALS transport (12h shifts, 7 24x7 ALS, 4 peak ALS, 3 QRVs, 1 supervisor QRV), 99% P+P
- Hospital-based interfacility transport and HEMS
- City fire all EMT-B
- County fire all EMT-B
- One volunteer EMT agency does limited transport B+B
- 2 hospitals in county (1 is trauma/pci center)
Industrial:
- BLS transporting ambulance (volunteer staffing, 24x7x365 as folks are on shift for regular work)
- Member of County 2's mutual aid plan, utilizes same radio system/protocols/equipment/training schedule
- Technical rescue / industrial fire brigade as well
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RUABadfish002
Forum Probie
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A couple of BLS ambulances staffed with 2 EMT-B's.
The rest are all ALS units staffed with dual medics, I/P. We still have I/99's here but due to the changes in the national scope that will soon be implemented, I/99's will be upgrading to P over the next few years.
The rest are all ALS units staffed with dual medics, I/P. We still have I/99's here but due to the changes in the national scope that will soon be implemented, I/99's will be upgrading to P over the next few years.
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Our 911 contract where I work is covered by one dedicated ALS ambulance (all company ALS units are double medic).
Another ALS ambulance and three BLS units are also based in that town, but are all available for transfers.
When the dedicated truck is out, if an ALS ambulance is in town, they will drive to the fire station for coverage and cannot take transfers. If only BLS is in town, they will go into coverage until relieved by another company ALS unit that comes in from elsewhere or the dedicated truck returns as soon as they cross town lines.
ALS can turf to BLS if transport is not "significantly delayed" by waiting for BLS to arrive.
The contract also mandates providing ALS intercept to a neighboring town with POC BLS ambulance. This must be done by the dedicated unit, even if a transfer ALS unit is available, which makes no sense.
The nearest trauma center and specialty hospital is in metro Boston which is a 45 minute transport. There are several non-designated community hospitals in the 15-20 minute range. One has a cath lab, and all are stroke centers.
Where I live now in Colorado Springs, AMR is the contracted provider for El Paso County. They provide ambulances to the city, other towns with no fire based ambulance, and unincorporated areas. One town contracts with another private company.
Colorado Springs has 20 ALS engines, 7 sometimes ALS trucks, and two ALS non-transporting ambulances in areas with high medical call volume.
Other towns have ALS Fire first response and AMR transport, or fire-based transporting ALS. Some towns are BLS first response only.
Peak AMR staffing county wide is 14 ALS ambulances I believe.
Two Level II specialty hospitals in town, one has a pediatric hospital as well. Two Level IIIs in the northern and less populated area of the county.
Another ALS ambulance and three BLS units are also based in that town, but are all available for transfers.
When the dedicated truck is out, if an ALS ambulance is in town, they will drive to the fire station for coverage and cannot take transfers. If only BLS is in town, they will go into coverage until relieved by another company ALS unit that comes in from elsewhere or the dedicated truck returns as soon as they cross town lines.
ALS can turf to BLS if transport is not "significantly delayed" by waiting for BLS to arrive.
The contract also mandates providing ALS intercept to a neighboring town with POC BLS ambulance. This must be done by the dedicated unit, even if a transfer ALS unit is available, which makes no sense.
The nearest trauma center and specialty hospital is in metro Boston which is a 45 minute transport. There are several non-designated community hospitals in the 15-20 minute range. One has a cath lab, and all are stroke centers.
Where I live now in Colorado Springs, AMR is the contracted provider for El Paso County. They provide ambulances to the city, other towns with no fire based ambulance, and unincorporated areas. One town contracts with another private company.
Colorado Springs has 20 ALS engines, 7 sometimes ALS trucks, and two ALS non-transporting ambulances in areas with high medical call volume.
Other towns have ALS Fire first response and AMR transport, or fire-based transporting ALS. Some towns are BLS first response only.
Peak AMR staffing county wide is 14 ALS ambulances I believe.
Two Level II specialty hospitals in town, one has a pediatric hospital as well. Two Level IIIs in the northern and less populated area of the county.
the_negro_puppy
Forum Asst. Chief
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we work:
Paramedic / Paramedic
or
Paramedic / Student Paramedic
We also have Intensive Care Paramedics that work on Helos and fly cars. They have extra cardiac drugs, cardioversion, pacing, intubation etc.
No fire involvement.
Paramedic / Paramedic
or
Paramedic / Student Paramedic
We also have Intensive Care Paramedics that work on Helos and fly cars. They have extra cardiac drugs, cardioversion, pacing, intubation etc.
No fire involvement.
EpiEMS
Forum Deputy Chief
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So, who handles heavy rescue down undah? Do PD and FD go to life-threatening calls to start CPR and early defib, etc.?
med51fl
Forum Lieutenant
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Ok so here it is:
Place #1-County-wide fire based EMS 24 / 48 shifts
-3 paramedics on the ambulance (all ALS)
-All 911 ALS transport, no IFT
-4 people on the fire truck (ALS), minimum of 2 paramedics, the others EMTs
-Ambulance first out to high accuity calls, fire truck out if ambulance already on a run
-Fire truck first out on low accuity calls
-BLS transport done by private ambulance
-HEMS done by fire department (as well as rescue / water-drops) manned by 2 pilots (EMT / paramedic) and 2 paramedics
-Ambulance crews also perform fireground duties (interior search / rescue, assist with fire attack, etc.)
-5 to 10 minute transports
Place #2-City EMS only department
-total transport with some IFT
-1 paramedic, 1 EMT crew configuration
- 20 to 30 minute transports
Place #1-County-wide fire based EMS 24 / 48 shifts
-3 paramedics on the ambulance (all ALS)
-All 911 ALS transport, no IFT
-4 people on the fire truck (ALS), minimum of 2 paramedics, the others EMTs
-Ambulance first out to high accuity calls, fire truck out if ambulance already on a run
-Fire truck first out on low accuity calls
-BLS transport done by private ambulance
-HEMS done by fire department (as well as rescue / water-drops) manned by 2 pilots (EMT / paramedic) and 2 paramedics
-Ambulance crews also perform fireground duties (interior search / rescue, assist with fire attack, etc.)
-5 to 10 minute transports
Place #2-City EMS only department
-total transport with some IFT
-1 paramedic, 1 EMT crew configuration
- 20 to 30 minute transports
fast65
Doogie Howser FP-C
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Private 911/IFT
- 1-Basic/1 medic, on occasion we'll have a dual medic car.
- 24/48, 4 ambulances on 24/7, in the summer we bring up a 12 hour car. We have quarters.
- We're the sole 911 provider for the county, and handle 99% of the IFT's. For CCT's we'll typically send out a page for a third person to meet us at the hospital.
- FD's around here are mostly volunteer, but have a few paid staff. Rarely do we get another paramedic on scene.
Fire based, dual role with EMS transport
37 ALS engines
41 ALS ambulances, 14 are dual medic
Volunteers can put a BLS or ALS ambulance in-service
14 ladder trucks/TL's, all BLS
8 Heavy rescues - all have ALS equipment, can be ALS if Trot/Hazmat tech happens to be ALS
Seven EMS supervisors in chase vehicles
Typical txp is 5-20 mins
Liberal mutual aid agreements with surrounding jurisdictions. Most give as much as they take, but two counties in particular use us all the time and rarely, if ever, give anything back. Other than mutual aid, the county does all EMS txp.
Schedule 24's - on, off, on, off, on, off x 4, no Kellys. Cannot work in excess of 36 scheduled hours
37 ALS engines
41 ALS ambulances, 14 are dual medic
Volunteers can put a BLS or ALS ambulance in-service
14 ladder trucks/TL's, all BLS
8 Heavy rescues - all have ALS equipment, can be ALS if Trot/Hazmat tech happens to be ALS
Seven EMS supervisors in chase vehicles
Typical txp is 5-20 mins
Liberal mutual aid agreements with surrounding jurisdictions. Most give as much as they take, but two counties in particular use us all the time and rarely, if ever, give anything back. Other than mutual aid, the county does all EMS txp.
Schedule 24's - on, off, on, off, on, off x 4, no Kellys. Cannot work in excess of 36 scheduled hours